Measuring Fatigue in Triage: A Pilot Study

: Given the critical nature of triage in facilitating emergency department (ED) functions, an understanding of the factors that impact triage nurses' ability to accurately assign triage scores and the ways in which these factors may affect various patient outcomes is extremely important; yet, there exists a paucity of such research in the literature. To further develop this knowledge base, an investigation of triage nurse fatigue and the role it may play in the ability to accurately assign triage scores was developed. The purpose of this pilot study was to determine how the length of a triage shift affects perceived fatigue levels among triage nurses. This pilot study was conducted using a prospective, descriptive cohort design with 28 registered nurses at a university-affiliated community hospital in the southeastern United States. Fatigue data were collected every 2 hr while the subject was in triage over the course of eighteen 24-hr periods between November 2015 and April 2016. Fatigue was measured using a self-reported fatigue questionnaire that included 2 validated fatigue scales: Karolinska Sleepiness Scale and Samn-Perelli Seven-Point Fatigue Scale. Data were analyzed using SPSS and Microsoft Excel. Results indicate a strong correlation between the amount of time spent in triage and fatigue scores, with average fatigue scores increasing by 64.4%-75.2% over the course of a 12-hr shift. Findings suggest that there was a positive correlation between the length of a triage shift and perceived fatigue levels among triage nurses in the ED. The biggest percent increase in fatigue scores is between hours 4 and 8. Further studies are needed to determine optimal triage shift length as well as the effect of nursing fatigue on triage accuracy.